This specification relates to assessing the cognitive function of a person to whom a cognitive test has been administered, and in particular to detection of cheating on a cognitive test.
Various techniques have been used to measure the cognitive function of a person. For example, the National Institute of Aging's Consortium to Establish a Registry of Alzheimer's Disease (CERAD) has developed a ten word list as part of the Consortium's neuropsychological battery. The CERAD word list (CWL) test consists of three immediate-recall trials of a ten word list, followed by an interference task lasting several minutes, and then a delayed-recall trial, with or without a delayed-cued-recall trial. The CWL is usually scored by recording the number of words recalled in each of the four trials. A single cutoff score for the delayed-recall trial, with or without adjustment for demographic variables, is typically used to determine whether cognitive impairment exists.
Some have proposed various improvements to the CWL. In addition, the CWL and the improvements thereof have been used to provide memory performance testing services, via the Internet, to clinicians in daily practice. Such services allow rapid testing of individual patients and reporting on the results of such testing. Previous reports for individual cognitive performance test results have included a statement of whether the patient has been found to be normal or to have cognitive impairment.
Furthermore, in the long-term care insurance industry, individuals applying for a policy must typically be determined to not have cognitive impairment or dementia due to Alzheimer's disease or a related disorder (ADRD). Insuring such an impaired individual can result in a typical claims cost of more than $200,000 per case, assuming four years of claims payments. The insurer therefore wishes to avoid insuring applicants who already have ADRD. For this reason, insurers pay underwriters to administer cognitive testing that is both sensitive to detect mild cognitive impairment, as well as specific to correctly identify normal aging. To reduce the costs of such cognitive testing, insurers are increasingly testing applicants over the telephone.